How Do You Stay Positive When Migraine Attacks?
A reader asks: “How do you stay positive when you get a migraine attack? I got a bad one today and had to leave work early. I have no idea what triggered it either. I feel weak and betrayed by my body. How can I change this?"
Staying positive during an attack is tough to do. I can’t imagine that many of us are smiling, laughing, or joking during a migraine attack. But I bet that’s not what you are asking, is it? Chances are, when an attack hits, you feel discouraged and frustrated. You also mentioned that you don’t know what triggered this particular attack and had to leave work. So fears about job security and letting others down start to creep in, too. Not knowing the trigger probably leaves you feeling like a helpless victim. After all, if you knew what triggered it, you could avoid it next time.
Finding the Trigger
Triggers can be really hard to identify. What sets off an attack this week may not have any affect next week. There are so many possible triggers and none of us respond the same to any of them. Keeping a meticulous headache diary can help identify some of our triggers. Yet, triggers are stackable. It’s rarely just one thing that sets migraine in motion. More likely, a combination of triggers over several hours or days will trigger an attack.
Occasionally I can skip a meal or have a bad night’s sleep without causing any migraine trouble. I can’t do that all the time though. If I were to wake up too early, skip breakfast, and rush out the door on a day when thunderstorms are in the forecast, I would probably get a migraine attack before noon. It’s the combination (trigger load) that set off that attack.
Not all triggers are that easily identified. Sometimes attacks appear random. So let’s take this from another perspective. If you knew what triggered the attack, would you beat yourself up for not avoiding it? Sometimes, knowing the trigger gives us more opportunity for unwarranted self-blame. Trigger or no trigger, you did not do anything to deserve the attack.
Missing work due to a migraine attack can feel like you are shirking your duties on the job. The fear of reprisals and guilt for not pulling your own weight is tremendous even if you do have a sympathetic boss. I know that when I was working, I would feel like I didn’t have the right to call in sick for any other illness because I already missed too much work because of migraine.
If you are missing work often, you may want to talk to your supervisor or HR department about using Family & Medical Leave (FMLA) benefits. This program was designed specifically to help employees with serious illnesses protect their jobs while still taking the necessary time off to address health concerns.
You also mentioned feeling betrayed by your body. That feeling can certainly affect our mood and is more common in those who are still struggling to accept migraine as part of their lives. When you see migraine as the “enemy” that is determined to “ruin your life” then it is easy to feel betrayed by your body. As difficult as it may seem right now, acceptance will help you respond to attacks without anger or self-blame. Remind yourself that migraine is a disease. You didn’t do anything to cause it. Your body isn’t out to get you. This is just part of life. It will take time to adjust to this new way of thinking, so go easy on yourself. If you find yourself struggling to accept migraine, then it may help to talk to a therapist who can help you challenge your thinking and develop new ways to approach migraine.
Mood Swings are a Symptom!
The neurological changes that take place during an attack often set off a wide range of emotions. Those emotional changes have a biological origin. Euphoria, irritability, depression, and anxiety have all been implicated as true biological symptoms of a migraine attack. Recognizing them for what they are can help us avoid blaming ourselves for imaginary character flaws.
Getting the Right Treatment
You didn’t mention if you are seeing a headache specialist or what treatments you are using. The mood challenges you are facing were much more common for me before I started getting good treatment from a headache specialist. By doing this, I learned how to respond to attacks early enough with the right abortive medication to stop most of them before symptoms got out of control. I lose fewer days to attacks now that I am getting the right treatment.
If you are getting more than 2-4 attacks per month and frequently losing days (i.e. missing work, leisure time, etc.) then it’s probably time to talk to your doctor about starting or changing preventive treatments. Plus, if the treatment you are using to stop attacks isn’t doing the job, it’s a good idea to talk to your doctor about changing that, too. The best kind of doctor to treat migraine is a headache specialist. If you’re not seeing one right now, check out the UCNS directory of headache specialists to find one near you.
Can you tell when a migraine attack is coming?